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• <br /> LAND USE PERMIT APPLICATION —Burnett County, WI g b <br /> v, N <br /> Applicant Complete All Sections Below This Line = to <br /> CD 1 <br /> M. <br /> Permit Types and Fees:(Please,check appropriate boxes) r 'f <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ` l - <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 V p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> 6 1, <br /> ic, Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ; <br /> Filling/Grading $150 Boathouse $500 ° <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ? ii <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> • <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> CD Ilb <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> lb <br /> Property Owner's Name: C.1--V-N r Es-1-;eh. WIC' Cab P.r, Q (N• <br /> . <br /> Property Owner's Mailing Address:t 1893 'R Q-cLo c od -S+ NvJ A rxa,t p 'i F.c n M S5 3 C1 n 16 <br /> cn <br /> City State Zip 4 ir <br /> Property Site Address: Cp 62;7 l 1— _ t n n R a at� o FA d <br /> Contact's Telephone Number: Co 11...._ %c)Li 53 it 1 a. • <br /> p ' , <br /> w <br /> Contact's Email: C h rn Cr... CrAr \c ..S} , ALA" <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °0 <br /> 5' <br /> @BurnettCountyWl.gov ao <br /> o <br /> Legal Description of Property: S 1'IS I o-G 5 S 8s ' S E I E <br /> Section#: ( Town#: 3 9 N Range#: R)fo W Town of: n'Ia., In o n <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* \ <br /> Tax ID#(1-5 digit number;found on tax statement): I I 9 0 (.. 5! <br /> Proposed Use of Structure/Addition: S-f- 1 s s W <br /> Anticipated Start Date: 4115 <br /> _ <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) n <br /> �tJ <br /> Building Contractor: Sewer Installer: <br /> Z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Offie&F Gat .c c <br /> 05k;rs -+A lA, A '7l vtd i- -6 t5cCee.,1 5 c--I-- t^/i Se <br /> kOc/t Fee Rec:C,. `,j 4= <br /> o Check#:)3�R( <br /> m <br /> r <br /> a <br /> z <br /> u 1 <br /> I m l_J <br /> Date of staff site visit: /J{' I �� Initi Is f site visi taff: ii6 < r- <br /> /. e, <br /> 9 a w r <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 7/���.j W m 11 t1 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o a a N Hu <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o N C <br /> Pagelof5 < a w H <br /> Burnett County,WI Land Use Application—Rev 5/2023 0 L� <br /> a <br /> K <br /> b <br />